PHOENIX-- According to autopsy reports released this month, Carol Gotbaum, who died in late September while in police custody at the airport in Phoenix, had acute ethanol and prescription medication intoxication at the time of her death.

Officially, Gotbaum, 45, died of asphyxia by hanging, and the death was ruled an accident by the Maricopa County medical examiner. Last week a private pathologist hired by the Gotbaum family (she was the stepdaughter-in-law of New York City Public Advocate Betsy Gotbaum) blamed police for her death.

When I first read about the circumstances of Gotbaum, I had a sinking feeling that she was an alcoholic, even though initial reports offered no indication of that. She had missed her connecting flight and apparently became so upset that airport security had to subdue her. Ultimately, they put her into a holding cell, shackled to a bench. She died as a result of this treatment. I couldn t help but wonder why no one thought to call for medical attention or for an ambulance if she was so hysterical. But I know why. She smelled of alcohol, and it seemed she had been drinking, so she wasn t considered sick.

The actions of the security personnel reflect the attitude that many people have toward alcohol. Gotbaum was heard yelling, I m not a terrorist, I m a sick mother, but her pleas were discounted. Because she appeared to be under the influence, it seems she was not seen as a human being in need of medical attention.

The thought that this situation was a medical emergency may not have even crossed the minds of the security personnel. Instead, it appears the security personnel based their actions on their unconscious feelings about individuals who drink.

Millions of people in the United States and around the world who suffer from chronic illnesses are treated with dignity and respect when their symptoms are present and obvious. Individuals with alcohol dependence are not so fortunate. Mostly they are shunned, disrespected and looked down upon by loved ones and society alike.

It s time for ignorance, shame and guilt to stop killing seriously ill people. Even though there has been progress in this area and, because of irrefutable biological evidence, today alcoholism is accepted as a disease by many scientific and medical experts, that s not enough. Carol Gotbaum s death clearly demonstrates that fact.

There are choking posters in most restaurants. There are signs in bars and restaurants that serve liquor warning of the dangers of alcohol to an unborn fetus. There are defibrillators on airplanes. These tools are the results of efforts to address serious public health issues. So if a significant portion of the world s population drinks alcohol, why isn t there an appropriate system in place to handle intoxication?

Police and security personnel should be trained to understand the seriousness of a drunk and disorderly event. Drunken behavior reflects the neurological effects of alcohol on the brain and should be deemed a medical emergency, not a criminal act.

There are innumerable reported instances of individuals who drank alcohol, fell asleep or passed out, regurgitated in their sleep and choked on their own vomit. For every reported incident of death as the result of this type of strangulation, there must be at least as many alcohol-related deaths that go unreported.

Alcoholism is a chronic disease, and it needs to be treated as such. When someone appears to be intoxicated, there should be procedures in place to prevent tragedy. The situation should be treated as a medical emergency; 911 should be called. The patient should be monitored for potential life-threatening problems like vomiting, seizures or respiratory or cardiac arrest.

It s distressing to think of how many people, having been labeled as unruly drunks, may have died in similar circumstances but their deaths went unnoticed because their families didn t have the clout that Carol Gotbaum s does. The attention this tragedy has received should help to change procedures. And the first rule for security personnel should be to obtain proper medical attention -- not to leave someone alone to suffer and die.

Rita Carol Barsky is a psychologist in Deer Park who specializes in the treatment of codependency and addiction.